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- W3184232011 abstract "The benefit of an implantable cardioverter-defibrillator (ICD) for primary prevention is controversial in the elderly. To evaluate the potential benefit of an ICD in different age groups, by assessing the differences in the risk of ventricular arrhythmia (VA) and non-arrhythmic mortality with increasing age. The study comprised 5170 primary prevention ICD recipients who were enrolled in 5 landmark ICD trials (MADIT-II, MADIT-RISK, MADIT-CRT, MADIT-RIT, RAID). Best-subsets Fine-and-Gray regression analysis was used to evaluate the risk for VA (sustained VT≥200/VF bpm) vs. non-arrhythmic mortality (defined as death without experiencing sustained VA) in 3 pre-specified age groups (<65, 65 to 74, and ≥75 years). In the youngest age-group (n=2502), the 3-year risk of VA was 2.25-fold higher than the competing risk of non-arrhythmic mortality (Figure: top-panel). In the intermediate age-group (n=1792), VA risk remained higher, but the difference was attenuated (Figure: middle-panel). In the older age-group (n=876), the risk of VA was lower than the risk of non-arrhythmic mortality (Figure: lower-panel). Multivariate analysis demonstrated that, compared to the younger age-group, patients in the older age-group experienced a significant 52% increased risk for non-arrhythmic mortality and a 40% lower risk for VA (p<0.001 for both). Our findings, based on 5 landmark ICD trials, show a graded reduction in the difference between the risk of life-threatening VA and non-arrhythmic mortality with increasing age. These findings suggest the need for more careful selection of candidates for primary ICD therapy in the older age-group." @default.
- W3184232011 created "2021-08-02" @default.
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- W3184232011 date "2021-08-01" @default.
- W3184232011 modified "2023-09-26" @default.
- W3184232011 title "B-AB11-02 COMPETING RISK OF VENTRICULAR ARRHYTHMIA AND NON-ARRHYTHMIC MORTALITY BY AGE: COMBINED ASSESSMENT FROM LANDMARK ICD TRIALS" @default.
- W3184232011 doi "https://doi.org/10.1016/j.hrthm.2021.06.065" @default.
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